PET/CT: What is it? Molecular Imaging. What is Nuclear Medicine?

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Mildred Jackson
5 years ago
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I am pleased to welcome you to The Harley Street Clinic s Molecular Imaging Centre housing the most comprehensive collection of ET/CT and Gamma Camera technology in the private sector in the UK The

Imaging Centre that is without equal in the private sector in the UK.

2 I am pleased to welcome you to The Harley Street Clinic s Molecular Imaging Centre housing the most comprehensive collection of ET/CT and Gamma Camera technology in the private sector in the UK The Harley Street Clinic part of HCA International which owns 6 major Central London Hospitals and operates 2 Cancer Centres in partnership with major NHS trusts has received significant investment in diagnostic and treatment facilities. Diagnostic investment has allowed us to upgrade our Gamma Cameras to include the very latest 3D technology which when combined with the ET/CT that was only recently installed, forms a Molecular Imaging Centre that is without equal in the private sector in the UK. In line with our ability at The Harley Street Clinic to treat complex cases for both adults and children, the Gamma Cameras are suitable for use for all ages including babies. The ET/CT is available for older children but they must be able to remain still for about half an hour whilst the scan takes place (determined on a case by case basis). This brochure introduces the concept of Molecular Imaging and then goes into some more detail about functionality and how to refer patients. Neil Buckley Chief Executive Officer The Harley Street Clinic

ET/CT: What is it? Molecular Imaging The Molecular Imaging Centre has at its disposal a latest generation ET / CT Scanner and two Gamma Cameras, one with SECT/CT capabilities.

In a nuclear medicine test, small amounts of radioactive materials are introduced into the body by injection, swallowing, or inhalation.

3 ET/CT: What is it? Molecular Imaging The Molecular Imaging Centre has at its disposal a latest generation ET / CT Scanner and two Gamma Cameras, one with SECT/CT capabilities. What is Nuclear Medicine? Nuclear Medicine imaging is a modality that investigates physiological processes within the body to diagnose and treat a variety of diseases. In a nuclear medicine test, small amounts of radioactive materials are introduced into the body by injection, swallowing, or inhalation. These tracers are absorbed by specific organs, bones, or tissues and emit gamma rays. These rays are detected by the gamma cameras and precise images are formed of the radiopharmaceutical distribution within the body. Benefits Nuclear medicine imaging is unique and provides many advantages over other methods of imaging. It provides doctors with information about both structure and function. It is a way to gather medical information that would otherwise be unavailable, require surgery, or necessitate more expensive diagnostic tests. Nuclear medicine imaging procedures often identify abnormalities very early in the progress of a disease - long before many medical problems are apparent on other diagnostic tests. One of the most important applications of ET is in oncology, where whole body imaging is used effectively to identify tumours at their source and scan for metastatic spread of the disease. ET imaging is playing an increasingly significant role in radiation therapy, particularly for cancer diagnosis and staging, and also as an aid in target delineation for treatment planning - ideally using a single ET/CT scan for both the staging and planning roles. Our ET/CT also is able to perform Diagnostic CT at the same patient visit. ET/CT scans are performed to: Detect cancer Determine whether a cancer has spread in the body Assess the effectiveness of a treatment plan, such as cancer therapy Determine if a cancer has returned after treatment Evaluate brain abnormalities, such as tumours, memory disorders and seizures Nuclear medicine tests are safe and generally painless. The amount of radiopharmaceutical used is carefully selected to provide the least amount of radiation exposure to the patient and ensure an accurate test.

However, there are areas where diagnostic CT is clearly superior.

4 Choosing between ET/CT or IV Contrast diagnostic CT with ET. The requirement for ET/CT or IV contrast diagnostic ET/CT will depend on the clinical scenario/ preference of the referring consultant and patient convenience. However, there are areas where diagnostic CT is clearly superior. These include: Detecting tiny pulmonary metastases Determining the relationship of tumour to anatomical structures/vessels (important with lung cancer pre surgery staging) and Tumours with mixed cell types (some lesions of which may have low tracer uptake and are only manifest on the CT portion.) Ordering a diagnostic CT may also be required for certain treatment protocols and will also reflect a physician s experience and comfort level with ET imaging. Benefits: By identifying changes in the body at the cellular level, ET imaging may detect the early onset of disease before it is evident on other imaging tests such as CT or MRI. By introducing IV Contrast Diagnostic ET/CT this offers greater convenience for the patient who undergoes two exams (IV Contrast diagnostic CT & ET) at one sitting, rather than at two different times. Referring for ET and a diagnostic CT If you would like a ET and a diagnostic CT, including the option of oral/iv contrast, this can also be accomplished during a single patient visit to The Molecular Imaging Centre. The ET portion is first performed as above (with a non-diagnostic CT) immediately followed by a diagnostic quality CT of the area specified (head, neck, chest, abdomen, and/ or pelvis) with oral and/or IV contrast if desired. This CT will be interpreted by a radiologist and a report provided. It is also reviewed by a Nuclear Medicine Consultant when reporting the ET scan. To obtain this type of study ask for a ET with IV Contrast Diagnostic CT (and specify CT head, neck, chest, abdomen, and/or pelvis and what type of contrast oral/iv/none). Remember that regardless of the diagnostic CT ordered, the whole body ET will always cover at least the top of the head through to the pelvis. So how can you refer patients to the ET/CT Scanner? Complete the Referral Form one is found in the flap at the rear of this brochure further copies are available from: The Harley Street Clinic Molecular Imaging Centre 154 Harley Street, London W1G 7LJ And on The Harley Street Clinic website Fax to or post to the above address Any queries please telephone us on Opening Times Monday Friday 08:30 17:30 Nuclear Medicine at 154 Harley Street Two state of the art gamma cameras are now available at 154 Harley Street. The SECT/CT provides true 3D information and improves diagnostic sensitivity. The introduction of this technique enables physicians to even more accurately localise areas of increased tracer uptake by overlying the functional SECT images with the detailed anatomical images of a CT scan. The Main clinical areas to benefit from SECT/CT are: Bone/Orthopaedic Imaging: Lower back pain-facet joint assessment /Joint rosthesis assessment / Bone and Joint infections / Occult fractures etc) Tumour Imaging: bone metastases / Tumour receptor imaging with MIBG and Octreotide Scans/ Thyroid Cancer arathyroid localisation and other endocrine tumours: SECT-CT permits accurate localisation, clarity and precision.

Examples of Cardiac Applications: Coronary Artery Disease Measure Effectiveness of Bypass Surgery Select atients for Bypass or Angioplasty Measure Chemotherapy Cardiac Toxicity Diagnostic Studies

5 Nuclear Medicine Applications CARDIOLOGY Cardiac nuclear medicine studies provide pictures of the structure and function of the heart. They help visualize blood flow patterns to the heart wall muscles and are used to help diagnose cardiac disease such as unexplained chest pain or chest pain brought on by exercise. Examples of Cardiac Applications: Coronary Artery Disease Measure Effectiveness of Bypass Surgery Select atients for Bypass or Angioplasty Measure Chemotherapy Cardiac Toxicity Diagnostic Studies performed: Myocardial erfusion Imaging MUGA NEUROLOGY rogress in nuclear medicine has always been a function of technological advances, and applications in neurology and psychiatry illustrate the point. Improvements in radiation detectors now allow for three-dimensional and quantitative mapping of the distribution of a labelled compound in the human brain. Neurologic Applications: 123I DaTSCAN is an invaluable imaging test to enable differentiation between both arkinsonian syndromes/ essential tremor and Alzheimer s disease/ probable dementia with Lewy bodies. The diagnostic accuracy of this test enables an early accurate diagnosis facilitating optimal patient management. ONCOLOGY The role of nuclear medicine in the diagnosis and management of malignant disease is constantly evolving. Advances in chemotherapy necessitate careful monitoring of the effects of chemotherapeutic drugs on normal organ function during follow-up, and tumour specific radiopharmaceuticals are being used for non-invasive, targeted tumour therapy. Radionuclide investigations play an important role in several aspects of follow-up in oncology patients. They may be used to determine adequacy of surgery or other primary therapy. We also offer therapeutic procedures such as radioactive iodine (I-131) therapy that uses radioactive material to treat cancer and other medical conditions affecting the thyroid gland. Oncologic Applications: Tumour Localization Tumour Staging Identify Metastatic Sites Assess Response to Therapy Relieve Bone ain Caused by Cancer Thyroid tissue deactivation/ ablation Diagnostic Studies erformed: Bone Scan MUGA GFR/ EDTA Test Octreotide Study MIBG Study Thyroid imaging Treatment Tests erformed: 131 Iodine- Thyroid Cancer Treatment/ Thyrotoxicosis 131 I-MIBG For neuroblastoma and phaeochromocytoma NEHROLOGY Nuclear Medicine renal scintigraphy provides important functional data for the diagnosis and management of patients with a variety of suspected genitourinary problems. A major area of renal scintigraphy is in the evaluation of obstructive uropathy with the introduction of diuretic renography. Imaging is also of proven value in trauma, renovascular hypertension, and acute and chronic renal failure. Renal Applications: Detect Urinary Tract Obstruction Detect Reflux after Urinary Tract Infection Diagnose Renovascular Hypertension Measure Differential Renal Function Detect Renal Transplant Rejection Detect yelonephritis Detect Renal Scars Diagnostic Studies erformed: Renal Cortical Scintigraphy (DMSA) Renogram +/- Diuretic (MAG3) Indirect Radionuclide Cystography Measurement of Glomerular Filtration Rate (GFR)

6 AEDIATRIC Nearly all Nuclear Medicine procedures can also be performed on paediatric patients. If the radiotracer is given intravenously, the child may feel a slight pin-prick when the needle is inserted into the vein. It is also important that the child remains very still while the images are being recorded. arents are encouraged to stay with their children to help them remain calm and still during imaging. Comfort items such as pacifiers, blankets and books are also very helpful. A television with children s programming is available in the scanning rooms. aediatric Applications: Urinary blockage in the kidney Backflow of urine from the bladder into the kidney Bone cancer, infections and trauma Gastrointestinal bleeding Tumours and the spread of cancerous cells in the body Jaundice in newborns and older children Diagnostic Studies erformed: Nephrology: Renogram +/- Diuretic (MAG3) Renal Cortical Scintigraphy (DMSA) Indirect Radionuclide Cystography Measurement of Glomerular Filtration Rate (GFR) Oncology: Bone Scan Octreotide Study MIBG Study Gastrointestinal: Meckels Diverticulum Study GI Bleed studies Gastric Emptying Gastrointestinal Gastrointestinal (GI) Nuclear Medicine methods play an important role in the present day practise of gastroenterology. Our department offers a wide range of diagnostic tests for patients experiencing GI symptoms. We are also one of the only private clinics to offer SeHCAT testing. This simple but accurate test can help clinicians diagnose bile salt malabsorption, a common cause of chronic diarrhoea. This condition can then be simply treated, without the need for any further tests and the patient regains their quality of life. Gastrointestinal Applications: Gastroparesis/Delayed Gastric Emptying Bile salt malabsorption Meckels Diverticulum Gastrointestinal bleeding Oesophageal motility disorders Cholecystitis Inflammatory Bowel Disease Diagnostic Studies erformed: Malabsorption (SeHCAT) Study Gastric Emptying Hepatobiliary (HIDA) Scan Meckels Study Gastrointestinal Bleed (GI) Study Oesophageal Transit Study So how can you refer patients for Nuclear Medicine Studies? Complete the Referral Form, detailing the type of test you require - a referral form is found in the flap at the rear of this brochure. Further copies are available from: The Harley Street Clinic Molecular Imaging Centre 154 Harley Street, London, W1G 7LJ and on The Harley Street Clinic website Fax to or post to the above address Any queries please telephone us on Opening Times Monday Friday 08:30 17:30

7 BAKER The Harley Street Clinic The Harley Street Clinic Molecular Imaging Centre M A R Y L E B O N E ADDINGTON ST. BLANDFORD ORTMAN SQUARE B A K E R S T R E E T CHILTERN NOTTINGHAM LACE MOXON LACE HIGH MANDEVILLE MARYLEB W I G M O R E S T R E E T JAMES ST. ONE DEVONSHIRE LACE WEYMOUTH WIMOLE H A R L E Y S T R E E T ARK CRESCENT L A C E R O A D DEVO N S H I R E S T O R T L AN D CAVENDISH L. REGENT S ARK NEW CAVENDISH WELBECK ST CAVENDISH SQUARE GREAT ORTLAND G R E A T O R T L A N D E U S T O N R O A D WARREN GOODGE MORTIMER ST GOODGE ST S T R E E T CLEVELAND T O T T E N H A M C O U R T R O A D EUSTON RD BEAUMONT L GRAFTON WAY MALE ST HOWLAND ST UNIVERSITY ST HUNTLEY ST CHENIES ST EUSTON SQUARE GOWER ST O X F O R D BOND REGENT S T R E E T OXFORD CIRCUS The Molecular Imaging Centre 154 Harley Street London W1G 7LJ The Harley Street Clinic website Or to the specific area of the site Telephone Fax anita.harte@hcahealthcare.co.uk Opening Times Monday Friday 08:30 17:30

Children's (Pediatric) Nuclear Medicine

Scan for mobile link. Children's (Pediatric) Nuclear Medicine Children s (pediatric) nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special camera and a computer